Self-harming: an individual journey

Self-harm describes a wide range of damaging acts that people do to themselves in a deliberate and usually hidden way, including cutting, burning, banging, hair-pulling, biting, swallowing or inserting objects as well as self-poisoning.

Importantly, self-harm is defined as inflicting immediate and direct physical damage or pain without the intent to kill oneself. Self-harming has many varied functions, but it is always a sign of emotional distress and that something is seriously wrong.

Because of the complex feelings involved, people often keep self-harm well-hidden from friends and family, going to great lengths to avoid showing the wounded area of the body. Typically, they only attend to the physical needs of their wounds and rarely are the underlying psychological causes addressed.

People self-harm for a number of reasons. For some it is means to cope with overwhelming emotions, a way to control feelings of helplessness and powerlessness; for others, self-harm temporarily combats feelings of numbness to the world around them. It is important to bear in mind that everybody's experience is unique, and there are no universal rules or reasons for self-harm.

There is no single factor leading to self-harm, but rather a series of overlapping internal and external pressures; being bullied at school; not getting on with parents; abuse; rape; bereavement and mental health problems such as depression, social isolation, etc.

Self-harm is not a reaction that switches on and off; most people that self-harm go through periods where they feel more vulnerable and periods where they can cope with triggers. Whilst self-harm is ultimately damaging and may be dangerous, for many people it provides a method of coping with life. Taking away a person's means of self-harm can increase the emotional distress and make the situation worse.

For many, the thought of someone wilfully hurting themselves is unsettling or even disgusting. This judgemental attitude further reduces confidence and self-esteem feeding into the cycle that leads to self-harm.

One of the most commonly reported areas where self-harm results in stigma is when people access medical help. This can often lead to people not staying to complete treatment, or being deterred from seeking treatment in the future. As a result, the secret live that “can’t be expressed” is driven further underground through shame.

Giving-up self-harm can be a long and difficult process. It is not something a person can just stop doing overnight, no matter the amount of willpower and desperation. No two individual journeys of recovery will be the same; some people use self-help groups or on-line support communities, others seek help from psychological therapies. These can help to build coping mechanisms to replace self-harm and address the feelings that originally led to the self-harming behaviours. Sometimes medication and/or therapy might be used to treat depression or another mental health problem that may be present.

Each individual needs a pathway to match their journey through life; we can’t separate their self-harming recovery from either their pressures or the strengths that will be the foundation for healing.

About the author

I'm a London based Chartered Clinical Psychologist and an Associate Fellow of the British Psychological Society working in inpatient services and private practice. I specialised in Personality Disruption and Self-harming from early in my career focusing on the underlying causes and sustainable ways to support sufferers out of their pain.